Kids vaccine rates must rise before school mask rules dropped, LI experts say

Some medical experts on Long Island say if Gov. Kathy Hochul wants to safely lift the mask mandate for schools, a far higher percentage of children must be vaccinated against COVID-19 — especially those ages 5 to 11.

And some say that won’t happen unless children are required to get the vaccine to attend school.

"The only way you can protect your kids without these masks is really to get them vaccinated," said Dr. Mundeep Kainth, a pediatric infectious disease specialist at Cohen Children’s Medical Center in New Hyde Park.

"The next thing the governor should do, the day she tells the schools that they don’t have to wear masks, is mandate a COVID vaccine for all kids in school," Kainth said.

Hochul has said that she will make a decision on school masks most likely during the first week of March after many students return from winter break on Feb. 28.

Appearing on MSNBC in December, she said a mandate of the vaccine for all eligible schoolchildren is "absolutely something we're looking at seriously," but that it would take legislative action.

She is under pressure from some parents who want the masks gone, and from the example of neighboring counterparts such as Gov. Phil Murphy, who has announced New Jersey will end its school mask mandate March 7.

That may be premature, according to some medical experts, unless the vaccination rates rise dramatically — and quickly.

About 70% of 12- to 17-year-olds in New York State are fully vaccinated, which infectious disease specialists say represents a good start toward the goal of a rate closer to 90% and higher. The figure on Long Island is about 69%.

The rate for children ages 5 to 11 is much lower — only about 32% are fully vaccinated, according to the Centers for Disease Control and Prevention. The figure on Long Island is about 28%.

Children under five are not yet eligible for the vaccine.

Hochul said Tuesday she will consider vaccination rates when deciding whether to lift the school mask mandate, as well as weighing positivity levels and other factors.

She added that "there’s not a magic number" that would prompt her to drop the mandate.

State health officials, asked Tuesday whether Hochul plans to require COVID-19 vaccinations for children, referred to comments she made in December explaining the legislature would also have to approve it.

"So that could not possibly happen at this time, it would have to happen for next fall," Hochul said at the time. "So it's absolutely something we're looking at."

Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children's Hospital, agreed that more children, especially younger ones, need to get vaccinated before the mask mandate can be safely dropped.

"My concern is that when we do go to unmask in schools, we will see a second surge amongst children who have not yet had COVID," Nachman said, adding that "prevention is key. Therefore, getting a vaccine before that happens will be very important."

Given current vaccine levels among children ages 5 to 11, Nachman said she thinks it is unlikely it will be safe or recommendable to drop the mask mandate in March.

NormaDeane Armstrong, a professor of epidemiology at Molloy College, agreed it is too soon to lift the mandate because of the low vaccination rates among the younger children.

"You’re not at that safe point," she said. Vaccination levels should be at least 80%, she said, and positivity levels should be low and stable for several weeks before dropping the mandate.

Kainth said that even if positivity levels and case numbers are relatively low, it is still imperative that more children get vaccinated because they can get seriously ill and hospitalized if infected with the virus. And that may require mandating the shots, given that some parents are resistant, she said.

"We know that those parents who are vaccine-hesitant are not going to show up and get that done unless you force the hand and say, ‘Hey you know, your kid is not going to be able to go to school unless you get them vaccinated,’" she said.

A small but growing number of children are getting infected with MIS-C, or multisystem inflammatory syndrome in children, several weeks after getting COVID-19, according to doctors.

The condition causes the inflammation of body parts including, potentially, the heart, lungs, kidneys, brain, skin, eyes or gastrointestinal organs, according to the CDC.

Armstrong said that if COVID-19 shots are mandated for school children, the vaccine would simply be added to the list of others required including against measles, chickenpox, and other illnesses.

If a COVID-19 shot is added to the required vaccination list by next fall, Nachman said she won't be surprised. "We want to keep our children safe," she said.

Medical experts said other factors also play into the decision of whether and when to lift the mask mandate.

One future development to monitor, Nachman said, is whether case numbers and positivity levels jump after Hochul's Thursday lifting of the mask or vaccine requirement for indoor public places including stores, restaurants, gyms and theaters.

Ideally, the seven-day positivity level should be at 1% or less, Nachman said. Currently, the Long Island seven-day average is 3.33%.

She said there are no absolute numbers that must be met, but rather it is a "bigger picture" scenario involving numerous factors.

"So is a third of the families protected sufficient? Clearly not," Nachman said. If 100% of the children were vaccinated, that would be great, "but that’s not realistic."

Medical experts said allowing high schools and middle schools to drop the mask mandate, but maintaining it in elementary schools because of the differing vaccination levels, probably would not work, in part because many families have children in the different age groups.

The latest COVID-19 indicators released Tuesday showed a continuing downward trend after hitting record levels during the omicron surge.

Long Island registered 321 new daily confirmed cases.

Statewide, 66 people including three in Nassau and two in Suffolk died on Monday of causes linked to the virus.

With Matt Clark

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